AG Issues Letter to Prescribers regarding Opioids

December 16, 2015

December 16, 2015

Dr. Timothy Oh, President
Maine Dental Association

Brian R. Pierce, M.D., President Maine Medical Association

Evelyn Kieltyka, President
Maine Nurse Practitioner Assn.

Irene Eaton, MSN, RN, CS, President ANA Maine Nurses Association

Lisa Gouldsbrough, D.O., President
Maine Osteopathic Association

Steve Blessington, PA-C, President Maine Assn. of Physician Assistants

Meghan Flanagan, DVM, President Maine Vet. Medical Association

Keith Kendall, DPM, President
Maine Podiatric Medical Assn.

The scourge of heroin and opioid abuse is an extraordinary crisis requiring an all hands on deck approach.

I need not recite the statistics, the anecdotes or the obituaries.

Perusing the attached case summary (de-identified) from the Chief Medical Examiner’s Office in one recent month is sufficient to make the problem dramatically clear: 21 apparent drug overdose deaths, roughly five a week, eight of them involving prescription medications.

No one group or sector is the cause of the problem or the source of the cure; nor will the problem be solved by a single act, a single piece of legislation or one governmental fiat. But your members and their staffs can be part of the solution by reining in the proliferation of opioid painkillers in our state, now tallying more than a million prescriptions each year.

There are several things you can do:

  1. Two days ago, the United States CDC proposed new guidelines for prescribers of opioids. https://www.washingtonpost.com/news/to-your-health/wp/2015/12/14/hoping-to-curb-the-prescription-opioid-epidemic-cdc-proposes-new-guidelines-for-doctors/ I urge you to review this proposal and to incorporate these suggestions in your practices wherever possible as soon as possible

  2. Medication-assisted treatment being one of the few modes of treatment known to wean addicts off drugs, I urge all of you who are eligible to become prescribers of buprenorphine.

  3. Most importantly, I urge you or your staff to check the Prescription Drug Monitoring Program before prescribing painkillers. Checking the PDMP is faster and easier than ever, and, while not mandated in this state, it is becoming standard practice across the country.

  4. In addition to the usual disclosures about prescription drugs, prescribers of painkillers and pharmacists dispensing them can also provide a warning about the misuse of these drugs. I have drafted such a warning that comports with the Maine Criminal Code, and that document is attached.

Other recommendations will be forthcoming soon from the Maine Anti-Heroin/Opiate Initiative headed by U.S. Attorney Thomas Delahanty, Public Safety Commissioner John Morris and me.

In the meantime, I thank you for your thoughtful and energetic cooperation in this critical effort.

Yours very truly,

Janet T. Mills Attorney General

cc:
Board of Licensure of Dental Examiners Board of Licensure in Medicine State Board of Nursing State Board of Optometry Board of Osteopathic Examiners and Registration Board of Licensure of Podiatrists State Board of Veterinary Medicine

Supporting documents

PDF of AG Letter to Prescribers with attachments 2015-12-16